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Christer Mjåset: 4 questions you should always ask your doctor
Krister Mjaset (Chhrister Mjaset): 4 pitanja koja treba uvek postaviti svom doktoru
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„Doktore, da li je to stvarno neophodno?” Na osnovu zapanjujuće statistike o preteranom lečenju, neurohirurg Krister Mjaset objašnjava moć ovog i drugih jednostavnih pitanja u vezi sa lečenjem i operacijom, i pokazuje kako pacijenti mogu bolje sarađivati sa doktorima kako bi dobili negu koja im je potrebna.
Christer Mjåset - Neurosurgeon
Christer Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models. Full bio
Christer Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models. Full bio
Double-click the English transcript below to play the video.
00:12
I am a neurosurgeon,
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Ja sam neurohirurg,
00:15
and I'm here to tell you today
that people like me need your help.
that people like me need your help.
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i ovde sam danas kako bih vam rekao
da ljudi kao ja trebaju vašu pomoć.
da ljudi kao ja trebaju vašu pomoć.
00:20
And in a few moments, I will tell you how.
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Kroz nekoliko sekundi ću vam reći i kako.
00:22
But first, let me start off by telling you
about a patient of mine.
about a patient of mine.
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Pre svega, dozvolite mi da počnem
sa pričom o jednom mom pacijentu.
sa pričom o jednom mom pacijentu.
00:26
This was a woman in her 50s,
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Reč je o ženi u šestoj deceniji života,
00:28
she was in generally good shape,
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generalno dobrog zdravlja,
00:31
but she had been in and out
of hospital a few times
of hospital a few times
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ali je nekoliko puta dolazila u bolnicu
00:33
due to curative breast cancer treatment.
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zbog lečenja raka dojke.
00:37
Now she had gotten a prolapse
from a cervical disc,
from a cervical disc,
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Sada je imala vratnu diskus herniju
00:40
giving her radiating pain of a tense kind,
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koja je izazivala
intenzivan bol koji se širio
intenzivan bol koji se širio
00:44
out into the right arm.
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kroz njenu desnu ruku.
00:47
Looking at her MRI
before the consultation,
before the consultation,
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Gledajući njenu magnetnu rezonancu,
pre konsultacija,
pre konsultacija,
00:49
I decided to suggest an operation.
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odlučio sam da joj predložim operaciju.
00:52
Now, neck operations like these
are standardized, and they're quick.
are standardized, and they're quick.
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Operacije vrata kao što je ova
su standardizovane i brze,
su standardizovane i brze,
00:57
But they carry a certain risk.
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ali nose određeni rizik.
00:58
You make an incision right here,
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Napravite rez ovde,
01:01
and you dissect carefully
past the trachea,
past the trachea,
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secirate pažljivo pored dušnika,
01:03
the esophagus,
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jednjaka,
01:05
and you try not to cut
into the internal carotid artery.
into the internal carotid artery.
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i pokušate da ne razrežete
unutrašnju karotidnu arteriju.
unutrašnju karotidnu arteriju.
01:08
(Laughter)
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(Smeh)
01:09
Then you bring in the microscope,
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Onda uzmete mikroskop,
01:12
and you carefully remove
the disc and the prolapse
the disc and the prolapse
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i pažljivo uklonite disk i prolaps
01:14
in the nerve root canal,
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kanala nervnog korena,
01:15
without damaging the cord
and the nerve root
and the nerve root
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bez oštećenja živca i nervnog korena
01:17
lying only millimeters underneath.
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koji leži samo nekoliko milimetara ispod.
01:20
The worst case scenario
is the damage to the cord,
is the damage to the cord,
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Najgori scenario je da se ošteti nerv,
01:23
which can result in paralysis
from the neck down.
from the neck down.
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što može dovesti
do paralize od vrata nadole.
do paralize od vrata nadole.
Dok sam objašnjavao ovo
pacijentkinji, ona je zaćutala.
pacijentkinji, ona je zaćutala.
01:28
Explaining this to the patient,
she fell silent.
she fell silent.
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01:31
And after a few moments,
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Nakon nekoliko trenutaka,
01:32
she uttered a few very decisive words
for me and for her.
for me and for her.
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izgovorila je nekoliko veoma
presudnih reči i za mene i za nju:
presudnih reči i za mene i za nju:
01:37
"Doctor, is this really necessary?"
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„Doktore, da li je to stvarno neophodno?”
01:41
(Laughter)
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(Smeh)
01:44
And you know what I realized,
right there and then?
right there and then?
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Znate šta sam shvatio, upravo tu i tada?
01:47
It was not.
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Nije bilo neophodno.
01:49
In fact, when I get patients
like this woman,
like this woman,
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U stvari, kad primim pacijenta
kao što je ova žena,
kao što je ova žena,
01:52
I tend to advise not to operate.
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obično ne savetujem operaciju.
01:55
So what made me do it this time?
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Šta me je nateralo da to učinim tada?
01:59
Well, you see,
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Vidite,
02:00
this prolapse was so delicate,
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ova hernija je bila tako delikatna,
02:03
I could practically see myself
pulling it out of the nerve root canal
pulling it out of the nerve root canal
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da sam bukvalno mogao da vidim sebe
kako je izvlačim iz korena nervnog kanala,
kako je izvlačim iz korena nervnog kanala,
02:06
before she entered the consultation room.
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pre nego što je ušla u ordinaciju.
02:09
I have to admit it,
I wanted to operate on her.
I wanted to operate on her.
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Priznajem, želeo sam da je operišem.
02:13
I'd love to operate on her.
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Želeo sam da izvršim operaciju na njoj.
02:15
Operating, after all,
is the most fun part of my job.
is the most fun part of my job.
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Operacija je, na kraju krajeva,
najzabavniji deo mog posla.
najzabavniji deo mog posla.
02:18
(Laughter)
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(Smeh)
02:22
I think you can relate to this feeling.
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Mislim da možete da shvatite to osećanje.
02:24
My architect neighbor says
he loves to just sit and draw
he loves to just sit and draw
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Moj komšija arhitekta kaže
da on voli samo da sedi, crta
da on voli samo da sedi, crta
02:28
and design houses.
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i dizajnira kuće.
02:30
He'd rather do that all day
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On bi radije to radio po ceo dan,
02:31
than talk to the client
paying for the house
paying for the house
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nego da razgovara
sa klijentom koji plaća za kuću,
sa klijentom koji plaća za kuću,
02:35
that might even give him
restrictions on what to do.
restrictions on what to do.
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koji bi mogao čak da mu stavi
ograničenja na to šta da uradi.
ograničenja na to šta da uradi.
02:39
But like every architect,
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Ali kao i svaki arhitekta,
02:40
every surgeon needs
to look their patient in the eye
to look their patient in the eye
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svaki hirurg treba da pogleda
svog pacijenta u oči
svog pacijenta u oči
02:43
and together with the patient,
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i da zajedno sa pacijentom
02:44
they need to decide on what is best
for the person having the operation.
for the person having the operation.
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odluči šta je najbolje
za osobu koja se operiše.
za osobu koja se operiše.
02:50
And that might sound easy.
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To možda zvuči lako.
02:51
But let's look at some statistics.
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Ali pogledajmo neke statističke podatke.
02:56
The tonsils are the two lumps
in the back of your throat.
in the back of your throat.
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Krajnici su dva ispupčenja
u pozadini vašeg grla.
u pozadini vašeg grla.
02:59
They can be removed surgically,
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Mogu se hirurški odstraniti,
03:01
and that's called a tonsillectomy.
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i to se zove tonzilektomija.
03:03
This chart shows the operation rate
of tonsillectomies in Norway
of tonsillectomies in Norway
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Ovaj grafikon pokazuje
stopu operacija krajnika u Norveškoj,
stopu operacija krajnika u Norveškoj,
03:07
in different regions.
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u različitim regionima.
03:09
What might strike you
is that there is twice the chance
is that there is twice the chance
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Ono što vas može iznenaditi
je da su duplo veće šanse
je da su duplo veće šanse
03:13
that your kid --
because this is for children --
because this is for children --
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da vaše dete - zato što je reč o deci -
03:16
will get a tonsillectomy in Finnmark
than in Trondheim.
than in Trondheim.
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ima operaciju krajnika
u Finmarku nego u Trondhajmu.
u Finmarku nego u Trondhajmu.
03:20
The indications
in both regions are the same.
in both regions are the same.
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Indikacije su iste u oba regiona.
03:24
There should be
no difference, but there is.
no difference, but there is.
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Ne bi trebalo da bude razlike,
ali ona postoji.
ali ona postoji.
03:26
Here's another chart.
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Evo još jednog grafikona.
03:28
The meniscus helps stabilize the knee
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Meniskus pomaže da se učvrsti koleno
03:30
and can be torn or fragmented acutely,
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i može biti pokidan
ili izrazito izlomljen,
ili izrazito izlomljen,
03:32
topically during sports like soccer.
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obično tokom bavljenja sportom
kao što je fudbal.
kao što je fudbal.
03:35
What you see here is the operation rate
for this condition.
for this condition.
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Ono što vidite ovde
je stopa operacija tog stanja.
je stopa operacija tog stanja.
03:39
And you see that the operation
rate in Møre og Romsdal
rate in Møre og Romsdal
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Vidite da je stopa operacije
u Mere og Romsdalu
u Mere og Romsdalu
03:43
is five times the operation
rate in Stavanger.
rate in Stavanger.
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pet puta veća od stope
operacije u Stavangeru.
operacije u Stavangeru.
03:47
Five times.
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Pet puta.
03:49
How can this be?
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Kako je to moguće?
03:50
Did the soccer players in Møre og Romsdal
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Da li igrači u Mere og Romsdalu
03:52
play more dirty
than elsewhere in the country?
than elsewhere in the country?
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igraju prljavije nego igde u zemlji?
03:54
(Laughter)
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(Smeh)
03:56
Probably not.
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Verovatno ne.
03:59
I added some information now.
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Sada sam dodao neke informacije.
04:01
What you see now
is the procedures performed
is the procedures performed
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Ovo što vidite su procedure izvedene
04:03
in public hospitals, in light blue,
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u državnim bolnicama, svetlo plavo,
04:05
the ones in private clinics
are light green.
are light green.
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i u privatnim klinikama, svetlo zeleno.
04:08
There is a lot of activity
in the private clinics
in the private clinics
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Dosta je aktivnosti na privatnim klinikama
04:11
in Møre og Romsdal, isn't there?
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u Mere og Romsdalu, zar ne?
04:14
What does this indicate?
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Šta nam to govori?
04:15
A possible economic motivation
to treat the patients.
to treat the patients.
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Moguća ekonomska motivacija
da se pacijent leči.
da se pacijent leči.
04:20
And there's more.
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Ima tu još toga.
04:23
Recent research has shown
that the difference of treatment effect
that the difference of treatment effect
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Nedavno istraživanje je pokazalo
da razlika u efektu lečenja
da razlika u efektu lečenja
04:27
between regular physical therapy
and operations for the knee --
and operations for the knee --
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između obične fizikalne terapije
i operacije kolena
i operacije kolena
04:30
there is no difference.
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ne postoji.
04:32
Meaning that most
of the procedures performed
of the procedures performed
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Što znači da se većina izvedenih operacija
04:36
on the chart I've just shown
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sa grafikona koji sam pokazao
04:38
could have been avoided,
even in Stavanger.
even in Stavanger.
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mogla izbeći, čak i u Stavangeru.
04:41
So what am I trying to tell you here?
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Šta pokušavam da vam kažem ovim?
04:44
Even though most indications
for treatments in the world
for treatments in the world
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Iako je, širom sveta,
većina simptoma za lečenje
većina simptoma za lečenje
04:49
are standardized,
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standardizovana,
04:50
there is a lot of unnecessary variation
of treatment decisions,
of treatment decisions,
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postoje brojne nepotrebne varijacije
u odlukama lečenja,
u odlukama lečenja,
04:54
especially in the Western world.
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posebno na zapadu.
04:57
Some people are not getting
the treatment that they need,
the treatment that they need,
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Neki ljudi ne dobijaju lečenje
koje im je potrebno,
koje im je potrebno,
05:01
but an even greater portion of you
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ali još veći deo vas
05:04
are being overtreated.
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dobija i previše lečenja.
05:08
"Doctor, is this really necessary?"
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„Doktore, da li je to stvarno neophodno?”
05:11
I've only heard that question
once in my career.
once in my career.
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Samo sam jednom čuo to pitanje
u celoj svojoj karijeri.
u celoj svojoj karijeri.
05:14
My colleagues say they never heard
these words from a patient.
these words from a patient.
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Moje kolege kažu da nikada
nisu čuli te reči od pacijenta.
nisu čuli te reči od pacijenta.
05:19
And to turn it the other way around,
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Ako to pogledamo sa druge strane,
koliko često mislite da ćete
od doktora dobiti „ne” kao odgovor,
od doktora dobiti „ne” kao odgovor,
05:21
how often do you think
you'll get a "no" from a doctor
you'll get a "no" from a doctor
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05:23
if you ask such a question?
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kada postavite ovakvo pitanje?
05:26
Researchers have investigated this,
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Istraživači su se bavili ovim,
05:28
and they come up
with about the same "no" rate
with about the same "no" rate
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i došli do iste stope „ne”
05:30
wherever they go.
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gde god bi otišli.
05:32
And that is 30 percent.
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A to iznosi oko 30 procenata.
05:33
Meaning, three out of 10 times,
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Što znači, tri od deset puta,
05:37
your doctor prescribes
or suggests something
or suggests something
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vaš doktor vam prepiše ili predloži nešto
05:41
that is completely unnecessary.
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što je potpuno nepotrebno.
05:46
And you know what they claim
the reason for this is?
the reason for this is?
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Znate šta navode kao razlog za to?
05:50
Patient pressure.
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Pritisak pacijenata.
05:52
In other words, you.
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Drugim rečima, vas.
05:54
You want something to be done.
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Vi želite da se nešto uradi.
05:58
A friend of mine came to me
for medical advice.
for medical advice.
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Prijatelj mi se obratio
radi medicinskog saveta.
radi medicinskog saveta.
06:01
This is a sporty guy,
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On je sportista,
06:02
he does a lot of cross-country skiing
in the winter time,
in the winter time,
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dosta praktikuje skijaško trčanje
u zimskom periodu,
u zimskom periodu,
06:05
he runs in the summer time.
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a u letnjem periodu trči.
06:07
And this time, he'd gotten a bad back ache
whenever he went jogging.
whenever he went jogging.
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Sada je imao jak bol u leđima
kad god bi otišao na trčanje.
kad god bi otišao na trčanje.
06:11
So much that he had to stop doing it.
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Toliko da je morao da prestane da trči.
06:15
I did an examination,
I questioned him thoroughly,
I questioned him thoroughly,
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Pregledao sam ga, temeljno ispitao,
06:18
and what I found out is
that he probably had a degenerated disc
that he probably had a degenerated disc
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i otkrio sam da verovatno ima
degenerisan disk
degenerisan disk
06:21
in the lower part of his spine.
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u donjem delu kičme.
06:24
Whenever it got strained, it hurt.
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Kada god bi se izvio, bolelo je.
06:28
He'd already taken up
swimming instead of jogging,
swimming instead of jogging,
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Već je počeo sa plivanjem umesto trčanja,
06:30
there was really nothing to do,
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ništa se tu nije moglo raditi,
06:32
so I told him, "You need
to be more selective
to be more selective
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pa sam mu rekao: „Moraš biti izbirljiviji
06:34
when it comes to training.
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kada je reč o vežbanju.
06:35
Some activities are good for you,
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Neke aktivnosti su dobre za tebe,
06:37
some are not."
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a neke nisu.”
06:39
His reply was,
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Njegov odgovor je bio:
06:41
"I want an MRI of my back."
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„Želim da mi se uradi MR leđa.”
06:45
"Why do you want an MRI?"
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„Zašto bi želeo MR?”
06:48
"I can get it for free
through my insurance at work."
through my insurance at work."
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„Mogu ga dobiti besplatno
kroz osiguranje sa posla.”
kroz osiguranje sa posla.”
06:51
"Come on," I said --
he was also, after all, my friend.
he was also, after all, my friend.
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„Ma, hajde,” rekao sam -
ipak je on bio moj prijatelj.
ipak je on bio moj prijatelj.
06:54
"That's not the real reason."
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„To nije stvarni razlog.”
06:56
"Well, I think it's going to be good
to see how bad it looks back there."
to see how bad it looks back there."
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„Mislim da će biti dobro
da se vidi koliko loše izgleda.”
da se vidi koliko loše izgleda.”
07:03
"When did you start interpreting
MRI scans?" I said.
MRI scans?" I said.
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„Kad si ti to počeo da tumačiš
MR snimke?”, pitao sam.
MR snimke?”, pitao sam.
07:06
(Laughter)
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(Smeh)
07:08
"Trust me on this.
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„Veruj mi.
07:10
You're not going to need the scan."
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Neće ti trebati skeniranje.”
07:12
"Well," he said,
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„Pa,” rekao je,
07:14
and after a while, he continued,
"It could be cancer."
"It could be cancer."
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i nakon pauze nastavio:
„mogao bi biti rak.”
„mogao bi biti rak.”
07:17
(Laughter)
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(Smeh)
07:20
He got the scan, obviously.
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Dobio je skeniranje, naravno.
07:22
And through his insurance at work,
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Kroz osiguranje sa posla,
07:24
he got to see one
of my colleagues at work,
of my colleagues at work,
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otišao je do jednog mog kolege,
koji mu je rekao za degenerisani disk,
07:26
telling him about the degenerated disc,
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07:28
that there was nothing to do,
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da tu nema šta da se radi,
07:30
and that he should keep on swimming
and quit the jogging.
and quit the jogging.
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da treba da nastavi sa plivanjem
i da prestane da trči.
i da prestane da trči.
07:36
After a while,
I met him again and he said,
I met him again and he said,
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Nakon određenog vremena,
ponovo sam ga sreo i on mi je rekao:
ponovo sam ga sreo i on mi je rekao:
07:38
"At least now I know what this is."
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„Bar sad znam šta mi je.”
07:40
But let me ask you a question.
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Da vas pitam nešto.
07:42
What if all of you in this room
with the same symptoms had an MRI?
with the same symptoms had an MRI?
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Šta bi bilo da ste svi vi ovde
sa istim simptomima išli na MR?
sa istim simptomima išli na MR?
07:46
And what if all the people in Norway
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Šta bi bilo kada bi svi ljudi u Norveškoj
07:49
had an MRI due to occasional back pain?
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išli na magnetnu rezonancu
zbog povremenih bolova u leđima?
zbog povremenih bolova u leđima?
07:54
The waiting list for an MRI
would quadruple, maybe even more.
would quadruple, maybe even more.
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Lista čekanja za MR bi bila
četiri puta duža, možda čak i više.
četiri puta duža, možda čak i više.
07:58
And you would all take
the spot on that list
the spot on that list
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Vi biste zauzeli mesto na toj listi
08:00
from someone who really had cancer.
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nekome ko stvarno ima rak.
08:03
So a good doctor sometimes says no,
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Dobar doktor nekad kaže „ne”,
08:07
but the sensible patient
also turns down, sometimes,
also turns down, sometimes,
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ali i razuman pacijent
takođe nekada odbije
takođe nekada odbije
08:11
an opportunity
to get diagnosed or treated.
to get diagnosed or treated.
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mogućnost dijagnostikovanja ili lečenja.
08:16
"Doctor, is this really necessary?"
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„Doktore, da li je to stvarno potrebno?”
08:20
I know this can be
a difficult question to ask.
a difficult question to ask.
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Znam da to može biti teško pitanje.
08:24
In fact, if you go back 50 years,
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U stvari, ako se vratite 50 godina unazad,
08:26
this was even considered rude.
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to se čak smatralo nepristojnim.
08:28
(Laughter)
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(Smeh)
08:29
If the doctor had decided
what to do with you,
what to do with you,
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Ako je doktor odlučio
šta će raditi sa vama,
šta će raditi sa vama,
08:32
that's what you did.
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to ste i radili.
08:35
A colleague of mine,
now a general practitioner,
now a general practitioner,
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Moja koleginica, sada lekar opšte prakse,
08:37
was sent away to a tuberculosis
sanatorium as a little girl,
sanatorium as a little girl,
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je kao dete poslata
u lečilište za tuberkulozu,
u lečilište za tuberkulozu,
08:42
for six months.
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na šest meseci.
08:43
It was a terrible trauma for her.
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To je bila grozna trauma za nju.
08:45
She later found out, as a grown-up,
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Kasnije je, kao odrasla, saznala
08:48
that her tests on tuberculosis
had been negative all along.
had been negative all along.
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da su njeni testovi na tuberkolozu
bili sve vreme negativni.
bili sve vreme negativni.
08:52
The doctor had sent her away
on nothing but wrong suspicion.
on nothing but wrong suspicion.
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Doktor ju je poslao tamo samo
na osnovu pogrešne sumnje.
na osnovu pogrešne sumnje.
08:56
No one had dared or even considered
confronting him about it.
confronting him about it.
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Niko nije smeo, niti čak pomislio,
da mu se suprotstavi.
da mu se suprotstavi.
09:01
Not even her parents.
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Čak ni njeni roditelji.
09:03
Today, the Norwegian health minister
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Danas, norveški ministar zdravlja
09:06
talks about the patient
health care service.
health care service.
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govori o zdravstvenoj usluzi pacijenata.
09:10
The patient is supposed to get advice
from the doctor about what to do.
from the doctor about what to do.
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Pacijent bi trebalo da dobije savet
od doktora šta treba da radi.
od doktora šta treba da radi.
09:16
This is great progress.
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Ovo je veliki napredak.
09:18
But it also puts more
responsibility on you.
responsibility on you.
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U isto vreme prebacuje
više odgovornosti na vas.
više odgovornosti na vas.
09:21
You need to get in the front seat
with your doctor
with your doctor
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Morate da sednete sa svojim doktorom
09:24
and start sharing
decisions on where to go.
decisions on where to go.
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i da počnete deliti odluke
o tome šta raditi.
o tome šta raditi.
09:27
So, the next time
you're in a doctor's office,
you're in a doctor's office,
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Dakle, sledeći put kada se budete
našli u doktorskoj ordinaciji,
našli u doktorskoj ordinaciji,
09:31
I want you to ask,
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želim da pitate:
09:32
"Doctor, is this really necessary?"
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„Doktore, da li je to stvarno neophodno?”
09:36
And in my female patient's case,
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U slučaju moje pacijentkinje,
09:38
the answer would be no,
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odgovor bi bio „ne”,
09:40
but an operation could also be justified.
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ali operacija bi takođe
mogla biti opravdana.
mogla biti opravdana.
09:44
"So doctors, what are the risks
attached to this operation?"
attached to this operation?"
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„Doktore, koji su rizici
vezani za ovu operaciju?”
vezani za ovu operaciju?”
09:49
Well, five to ten percent of patients
will have worsening of pain symptoms.
will have worsening of pain symptoms.
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Pa, pet od deset procenata pacijenata
će imati povećane simptome bola.
će imati povećane simptome bola.
09:55
One to two percent of patients
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Jedan do dva procenta pacijenata
09:57
will have an infection in the wound
or even a rehemorrhage
or even a rehemorrhage
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imaće infekciju rane
ili čak ponovno krvarenje,
ili čak ponovno krvarenje,
10:00
that might end up in a re-operation.
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koje može dovesti do ponovne operacije.
10:04
0.5 percent of patients
also experience permanent hoarseness
also experience permanent hoarseness
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Takođe, 0,5 procenata pacijenata
ima trajnu promuklost,
ima trajnu promuklost,
10:07
and a few, but still a few,
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a nekolicina, ali ipak nekoliko njih,
10:09
will experience reduced function
in the arms or even legs.
in the arms or even legs.
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će imati smanjenu pokretljivost
u rukama, pa čak i nogama.
u rukama, pa čak i nogama.
10:15
"Doctor, are there other options?"
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„Doktore, ima li drugih opcija?”
10:18
Yes, rest and physical therapy
over some time
over some time
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Da, odmor i fizikalna terapija
nakon određenog vremena
nakon određenog vremena
10:21
might get you perfectly well.
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mogu dovesti do potpunog ozdravljenja.
10:25
"And what happens if I don't do anything?"
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„Šta će se desiti ako ništa ne uradim?”
10:27
It's not recommended,
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To nije preporučljivo,
10:29
but even then, there's a slight chance
that you will get well.
that you will get well.
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ali čak i tad, postoji mala šansa
da ćete ozdraviti.
da ćete ozdraviti.
10:33
Four questions.
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Četiri pitanja.
10:34
Simple questions.
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Jednostavna pitanja.
10:36
Consider them your new toolbox to help us.
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Razmišljajte o njima kao o vašem
novom setu za pomoć doktorima.
novom setu za pomoć doktorima.
10:40
Is this really necessary?
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Da li je to stvarno neophodno?
10:42
What are the risks?
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Koji su rizici?
10:44
Are there other options?
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Da li postoje druge opcije?
10:45
And what happens if I don't do anything?
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Šta će se desiti ako ništa ne preduzmem?
10:49
Ask them when your doctor
wants to send you to an MRI,
wants to send you to an MRI,
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Postavite ih kada doktor želi
da vas pošalje na MR,
da vas pošalje na MR,
10:53
when he prescribes antibiotics
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kada vam prepiše antibiotik
10:55
or suggests an operation.
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ili predloži operaciju.
10:58
What we know from research
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Ono što znamo na osnovu istraživanja
11:00
is that one out of five
of you, 20 percent,
of you, 20 percent,
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je da će jedno od vas pet,
znači, 20 procenata,
znači, 20 procenata,
11:03
will change your opinion on what to do.
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promeniti svoje mišljenje
o pitanju toga šta će učiniti.
o pitanju toga šta će učiniti.
11:06
And by doing that, you will
not only have made your life
not only have made your life
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Time ne samo da ćete
svoj život učiniti lakšim,
svoj život učiniti lakšim,
11:09
a whole lot easier,
and probably even better,
and probably even better,
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i verovatno boljim,
11:13
but the whole health care sector
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nego će i ceo zdravstveni sistem
11:15
will have benefited from your decision.
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imati koristi od vaše odluke.
11:19
Thank you.
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Hvala vam.
11:20
(Applause)
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(Aplauz)
ABOUT THE SPEAKER
Christer Mjåset - NeurosurgeonChrister Mjåset, M.D. is a neurosurgeon, author, columnist and lecturer who currently works as a Harkness fellow in Health Care Policy and Practice at Harvard T.H. Chan School of Public Health in Boston studying value-based health care models.
Why you should listen
Christer Mjåset, M.D. holds a position as a researcher at the Oslo University Hospital analyzing data from The Norwegian Spine Registry and as a lecturer at the Department of Health Management and Economics, University of Oslo, where he teaches in a leadership program for young physicians. Mjåset was president of the Norwegian Junior Doctors 2015-2019 and the Vice President of the Norwegian Medical Association 2017-2019. This work led him to be involved with the international Choosing Wisely campaign which seeks to advance a national dialogue avoiding unnecessary medical tests, treatments and procedures. From 2017-2019 he was responsible for implementing the campaign in Norway
Mjåset is a published author of five fictional books and several short stories. He won the Oslo City Cultural Scholarship for writers in 2006. He got his medical degree and bachelor’s degree in literature and philosophy at University of Oslo, both in 2000.
Christer Mjåset | Speaker | TED.com